Dear Doc: Very Painful Sex

Q: Doctor, I have been experiencing very bad pain during sex. This has been happening since I had my second child last year, which was a very difficult birth.

Now, whenever my husband enters me, I feel a very sharp jab of pain. It is so bad that it makes me cry. Fortunately, it eases off after maybe five-six minutes. But it is making our sex life very difficult.

Fortunately, my man is extremely understanding. But I am afraid that he will get tired of my complaining, and look for a girl who does not cry during sex!

A: Sounds like this pain is caused from something that happened when you were giving birth. Unfortunately, painful sex is very common after childbirth. In fact, new research from Australia has shown that after having a baby, most women do experience significant pain when they first have intercourse.

The Aussie team also found that sexual pain is more likely to occur if the woman has had some kind of surgical 'work' during the delivery - like a cut, or stitches. Also, a Caesarean operation does seem to moderately increase the risk of painful intercourse.

Fortunately, everything usually starts improving after a while. Nevertheless, the Australians have found that:

• Three months after delivery, 44.7 per cent of mothers still have pain during sex;

• Six months after delivery, the figure is 43.4 per cent;

• A year after delivery, the figure is 28.1 per cent;

• Eighteen months after delivery, it is still 23.4 per cent.

These figures show clearly that men need to take things gentle with a partner who has recently given birth. Also, I strongly recommend that during the year or so after childbirth, couples should use a lot of a sex lubricant, such as K-Y Jelly or Liquid Silk.

Now in your case, it is well over a year since you have given birth and you are still experiencing a lot of pain, so it is definitely time to do something about this.

Therefore, I suggest you go and see a doctor (ideally, a gynecologist), and ask he/she to do an internal examination, to see if there is anything that could be corrected. For instance, I have occasionally seen cases where a stitch was left behind following childbirth. Removal of the stitch cured the pain.

I am optimistic that eventually everything will be OK for you. But you must have that medical assessment.

In the interim, you could try different positions during intercourse. Very often, a woman finds that there are certain positions in which she experiences little or no pain at all.

Q: Recently, I have been having some slight difficulty with my erections. When I went to see my doctor, I was very surprised when he asked me how often I shave.

Seems like a strange question. Why did he ask it?

A: The answer is simple - men who have to shave very often, will almost always have a pretty high level of male hormone (testosterone). In contrast, men who only have to shave once a week or so, may sometimes have a rather low level of this hormone.

I hope your doctor has been able to help you. If not, please write to me again.

Q: At age 34, I am considering my options for contraception. Doc, which is more effective - the Pill or the coil?

A: Well, the Pill is slightly more effective in preventing pregnancy. It is generally accepted that the efficiency of the Pill is nearly 100 per cent - if you take it exactly as prescribed, and do not miss any!

As it relates to the coil (the IUD), its effectiveness is around 99 per cent. What this means is that if 100 women use the IUD for a year, then perhaps ONE of them may get pregnant.

At age 34, deciding which method of contraception to use is not always easy. If in doubt, talk it over with a doctor or a nurse.

Q: I am considering marrying a much older man. In fact, I am 30, and he is 70!

Doc, what I want to know is this - will he still be able to have sex?

A: Probably. A useful rule is that at age 70, around 70 per cent of men are still 'potent'. In other words, they can get an erection and have sex.

And even if your new husband cannot easily obtain an erection, drugs like Viagra and Cialis would probably enable him to do so.

Q: We are a couple in our late 20s, and although we have been trying for six months to conceive, we have been unsuccessful. So what is the best time of the month to try to conceive?

A: In general, if the menses arrive fairly regularly - around every 26 to 28 days, then the best time to try for a baby is

12 to 14 days after the start of a period.

But if you don't succeed fairly soon (like, after another three months), then I feel you should seek medical help. Both of you would then need some simple tests.

Q: Doc, last week I kissed a man who I now believe may have HIV. Is it possible that I could have caught the virus from this experience?

A: That is unlikely. Kissing does not often transmit HIV, although the chances are somewhat increased if it is very intimate (or 'French') kissing, using the tongues.

I really do not think you should worry about this. Maybe you could find out whether this man really does have HIV or not?

If he does, then you could arrange to have a blood test.

But the odds are that it will be

negative.

Q: I am a 29-year-old guy, and I really do not know very much about women. In fact, I am a virgin.

But now I have met a very

special woman, and she has invited me to go to bed with her.

Doc, what I want to know is, I have heard that there is some

special 'secret point' on a women, which they like men to stimulate.

Is this true? And if so, what is it?

A: Well, there is quite a bit of truth in what you have heard. The 'special point' which you are talking about is called the 'clitoris.' Unfortunately, it is a structure which a lot of men neglect!

You would find it useful to look at a website which is run by a famous condom manufacturer. Just tap in the words 'How to pleasure a woman', and you will receive some good advice.

However, your best guide as to how to behave in bed should be your new lady. Ask her what she finds pleasurable - and do it.

Q: Doc, I am considering going on that 'Mini-Pill'. But does it have any side effects?

A: Well, in medicine everything can have side effects. But the Mini-Pill is certainly a 'mild' thing, compared with the ordinary Pill.

However, it can cause tenderness of the breast, headache, weight changes and sometimes spots on the skin.

Also, it can give you dizziness and irregular menses. Some docs think it can cause mood swings.

The doctor who prescribes it for you can give you more information about rarer side effects.